Purpose: This study examined online gambling patterns among Korean adolescents during the COVID-19 pandemic and identified predictors of problem gambling based on a socio-ecological model. Methods: It used nationally representative data from the 2020 National Survey on Youth Gambling Problems conducted by the Korea Center on Gambling Problems. This study selected a sample of 780 adolescents aged 13–18 years who reported having gambled online at least once in the last three months from the raw data of respondents. They were classified as the non-problem group and problem group according to the Gambling Problems Severity Scale (GPSS) of the Canadian Adolescent Gambling Inventory (CAGI). The predictive factors of problem gambling were analyzed by logistic regression analysis. Results: The prevalence of problem gambling was 24.6 %. Its predictors included intrapersonal [male (odds ratios, OR = 1.67); gambling prior to COVID-19 (OR = 2.08)] and interpersonal factors [frequent gamblers in peers (OR = 4.34); peer pressure (OR = 2.34)]. Social factors, such as gambling in online community (OR = 5.60), sports betting (OR = 53.24), and lotteries (OR = 17.03) were associated with problem gambling. Conclusions The major predictors of problem gambling among adolescent online gamblers included peer gambling and specific types of gambling. To prevent problem gambling, strategies targeting peer groups are essential. In addition, nurses need to share with families, schools, communities, and policymakers that online gambling, such as lotteries and sports betting, are high-risk of adolescent problem gambling, and recommend them to collaborate for stricter regulatory measures.

Objective: We aimed to present the study design and baseline cross-sectional participant characteristics of biobank innovations for chronic cerebrovascular disease with Alzheimer’s disease study (BICWALZS) participants. Methods: A total of 1,013 participants were enrolled in BICWALZS from October 2016 to December 2020. All participants underwent clinical assessments, basic blood tests, and standardized neuropsychological tests (n=1,013). We performed brain magnetic resonance imaging (MRI, n=817), brain amyloid positron emission tomography (PET, n=713), single nucleotide polymorphism microarray chip (K-Chip, n=949), locomotor activity assessment (actigraphy, n=200), and patient-derived dermal fibroblast sampling (n=175) on a subset of participants. Results: The mean age was 72.8 years, and 658 (65.0%) were females. Based on clinical assessments, total of 168, 534, 211, 80, and 20 had subjective cognitive decline, mild cognitive impairment (MCI), Alzheimer’s dementia, vascular dementia, and other types of dementia or not otherwise specified, respectively. Based on neuroimaging biomarkers and cognition, 199, 159, 78, and 204 were cognitively normal (CN), Alzheimer’s disease (AD)-related cognitive impairment, vascular cognitive impairment, and not otherwise specified due to mixed pathology (NOS). Each group exhibited many differences in various clinical, neuropsychological, and neuroimaging results at baseline. Baseline characteristics of BICWALZS participants in the MCI, AD, and vascular dementia groups were generally acceptable and consistent with 26 worldwide dementia cohorts and another independent AD cohort in Korea. Conclusion The BICWALZS is a prospective and longitudinal study assessing various clinical and biomarker characteristics in older adults with cognitive complaints. Details of the recruitment process, methodology, and baseline assessment results are described in this paper.

Objectives: This study determines the effects of comorbidity of mood disorder and alcohol use disorder on suicide behavior. Methods: We converted data from the electronic medical records of one university hospital into a common data model and utilized it in our analysis. We selected 9551 patients with diagnosis codes of mood disorders or alcohol use disorders and divided them into three groups: mood disorder (MD) only, alcohol use disorder (AUD) only, and comorbidity of mood disorder and alcohol use disorder (MD+AUD). The mood disorder group was also subgrouped with depressive (DD) or bipolar affective disorder (BD) groups, and the comorbidity group was classified in the same way. Then, we applied logistic regression analysis to assess the risk of suicide attempts between the diagnostic groups. Subgroup analysis according to age also was conducted. Results: The MD+AUD group had 2.7 (odd ratio [OR]=2.70, 95% confidence intervals [CI]=1.91– 3.81, p<0.0001) and the DD+AUD group had 2.78 (OR=2.78, 95% CI=1.95–3.98, p<0.0001) times higher risk of suicide attempts than the MD only and DD only group, respectively. Furthermore, according to the age subgroup, the risk of suicide attempts was the highest (OR=5.17, 95% CI=2.35–11.40, p<0.0001) in the DD+AUD group for those aged 40–59. There were no significant results in BD. Conclusion The results showed that the comorbidity of mood disorder and alcohol use disorder could increase suicide risk. This study suggested that alcohol use behavior needs to be assessed as well as mood symptoms for suicide prevention.

The accuracy and convenience of continuous glucose monitoring (CGM), which efficiently evaluates glycemic variability and hypoglycemia, are improving. There are two types of CGM: professional CGM and personal CGM. Personal CGM is subdivided into real-time CGM (rt-CGM) and intermittently scanned CGM (isCGM). CGM is being emphasized in both domestic and foreign diabetes management guidelines. Regardless of age or type of diabetes, CGM is useful for diabetic patients undergoing multiple insulin injection therapy or using an insulin pump. rt-CGM is recommended for all adults with type 1 diabetes (T1D), and can also be used in type 2 diabetes (T2D) treatments using multiple insulin injections. In some cases, short-term or intermittent use of CGM may be helpful for patients with T2D who use insulin therapy other than multiple insulin injections and/or oral hypoglycemic agents. CGM can help to achieve A1C targets in diabetes patients during pregnancy. CGM is a safe and cost-effective alternative to self-monitoring blood glucose in T1D and some T2D patients. CGM used in diabetes management works optimally with proper education, training, and follow up. To achieve the activation of CGM and its associated benefits, it is necessary to secure sufficient repetitive training and time for data analysis, management, and education. Various supports such as compensation, insurance coverage expansion, and reimbursement are required to increase the effectiveness of CGM while considering the scale of benefit recipients, policy priorities, and financial requirements.

Objectives: This study determines the effects of comorbidity of mood disorder and alcohol use disorder on suicide behavior. Methods: We converted data from the electronic medical records of one university hospital into a common data model and utilized it in our analysis. We selected 9551 patients with diagnosis codes of mood disorders or alcohol use disorders and divided them into three groups: mood disorder (MD) only, alcohol use disorder (AUD) only, and comorbidity of mood disorder and alcohol use disorder (MD+AUD). The mood disorder group was also subgrouped with depressive (DD) or bipolar affective disorder (BD) groups, and the comorbidity group was classified in the same way. Then, we applied logistic regression analysis to assess the risk of suicide attempts between the diagnostic groups. Subgroup analysis according to age also was conducted. Results: The MD+AUD group had 2.7 (odd ratio [OR]=2.70, 95% confidence intervals [CI]=1.91– 3.81, p<0.0001) and the DD+AUD group had 2.78 (OR=2.78, 95% CI=1.95–3.98, p<0.0001) times higher risk of suicide attempts than the MD only and DD only group, respectively. Furthermore, according to the age subgroup, the risk of suicide attempts was the highest (OR=5.17, 95% CI=2.35–11.40, p<0.0001) in the DD+AUD group for those aged 40–59. There were no significant results in BD. Conclusion The results showed that the comorbidity of mood disorder and alcohol use disorder could increase suicide risk. This study suggested that alcohol use behavior needs to be assessed as well as mood symptoms for suicide prevention.

Many previous studies have shown reduced glucose uptake in the ischemic brain. In contrast, in a permanent unilateral common carotid artery occlusion (UCCAO) mouse model, our pilot experiments using 18F-fluorodeoxyglucose positron emission tomography (FDG PET) revealed that a subset of mice exhibited conspicuously high uptake of glucose in the ipsilateral hemisphere at 1 week post-occlusion (asymmetric group), whereas other mice showed symmetric uptake in both hemispheres (symmetric group). Thus, we aimed to understand the discrepancy between the two groups. Cerebral blood flow and histological/metabolic changes were analyzed using laser Doppler flowmetry and immunohistochemistry/Western blotting, respectively. Contrary to the increased glucose uptake observed in the ischemic cerebral hemisphere on FDG PET (p<0.001), cerebral blood flow tended to be lower in the asymmetric group than in the symmetric group (right to left ratio [%], 36.4±21.8 vs. 58.0±24.8, p=0.059). Neuronal death was observed only in the ischemic hemisphere of the asymmetric group. In contrast, astrocytes were more activated in the asymmetric group than in the symmetric group (p<0.05). Glucose transporter-1, and monocarboxylate transporter-1 were also upregulated in the asymmetric group, compared with the symmetric group (p<0.05, respectively). These results suggest that the increased FDG uptake was associated with relatively severe ischemia, and glucose transporter-1 upregulation and astrocyte activation. Glucose metabolism may thus be a compensatory mechanism in the moderately severe ischemic brain.

PURPOSE: This study was to evaluate the quality of online health information related to infants and preschoolers accessible through mobile applications and websites. METHODS: Using combinations of the terms 'infant', 'preschooler', and 'health' as the main keyword or categories, the researchers searched relevant mobile applications and websites in Korean application markets and popular search engines. Twelve mobile application and 14 websites were finally selected according to our inclusion criteria and evaluated using DISCERN instrument. RESULTS: The overall quality score of online health information available through mobile applications was 2.00 of 5 points, the reliability score was 2.15, and the quality score was 1.76. The overall quality score of online health information available through websites was 2.29, the reliability score was 2.40, and the quality score was 1.82. CONCLUSION: The quality of online health information related to young children was found to be low and to have potentially significant drawbacks according to DISCERN criteria. Therefore, it is necessary to establish a system to evaluate and regulate the quality of online health information. Additionally, factors that readers can use to judge the quality of health information, such as references and the benefit versus risks of the information, should be provided.
Child ; Consumer Health Information ; Humans ; Infant ; Internet ; Mobile Applications ; Search Engine

PURPOSE: The aim of this study was to assess the characteristics of papillary thyroid carcinoma (PTC) in patients aged 65 and older in order to predict postoperative recurrence based on the results of ultrasonographic surveillance. METHODS: Among 1,494 patients (200 male and 1,294 female; mean age, 46.6±11.3 years) who underwent surgery for thyroid cancer at our institution between 2006 and 2015, we retrospectively enrolled 150 PTC patients (29 male and 121 female; mean age, 69.4±4.2 years). To identify the risk factors for recurrence, we analyzed age, gender, multiplicity, size, number, extrathyroidal extension (ETE) of the tumor, lymph node metastasis (LNM), type of surgery, and the dose of radioactive ablation using a Cox regression model to identify hazard ratios (HRs). RESULTS: Among the 115 asymptomatic patients with PTCs detected by screening ultrasonography (n=86), other cross-sectional imaging modalities (computed tomography or positron emission tomography-computed tomography, n=13), or incidentally through a surgical specimen (n=16), 78 patients were confirmed to have papillary thyroid microcarcinomas (PTMCs). The other 35 patients presented with palpable neck masses (n=25), vocal cord palsy (n=9) or blood-tinged sputum (n=1). During the follow-up period (mean, 43.6 months), 17 patients (12.5%) experienced recurrence in the neck. None of the patients died due to PTC-related recurrence or distant metastasis during the follow-up period. Cox regression analysis demonstrated that tumor size (HR, 2.12; P<0.001) and LNM (central LNM: HR, 9.08; P=0.004; lateral LNM: HR, 14.71; P=0.002; both central and lateral LNM: HR, 58.41; P<0.001) significantly increased the recurrence rate. ETE, LNM, and recurrence were significantly less frequent in PTMCs than in non-PTMC (all P<0.001). CONCLUSION: PTCs of small size and absent LNM showed significantly better prognoses in patients 65 years and older.
Aged* ; Electrons ; Female ; Follow-Up Studies ; Humans ; Korea* ; Lymph Nodes ; Male ; Mass Screening ; Neck ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Retrospective Studies ; Risk Factors ; Sputum ; Thyroid Gland* ; Thyroid Neoplasms* ; Ultrasonography* ; Vocal Cord Paralysis

The aim of this study was to observe the effects of prophylactic palivizumab on hospitalization secondary to respiratory syncytial virus (RSV) infection (RSVhospitalization) in former very low birth weight infants (VLBWI) with bronchopulmonary dysplasia (BPD). This study also sought to identify the risk factors of RSVhospitalizationin this particular infant population. A prospective observational study was conducted between September 2007 and April 2008 in seven Korean hospitals. Children with a history of very low birth weight, a diagnosis of BPD and who were <2 yr old at the onset of the RSV season were included in this study. Palivizumab injections were administered monthly for a maximum of five months during the RSV season. RSVhospitalization rates were reviewed, and RSVhospitalization rates between subgroups were categorized by gestational age, birth weight, and duration of ventilator care. A total of 90 subjects completed the follow-up interviews. The mean gestational age at birth was 26.1+/-1.7 weeks, and the mean birth weight was 889.4+/-222.2 g. The incidence of RSVhospitalization in the study population was 8.9% (8/90), and the mean hospital stay was 11.0+/-5.5 days, including one death. There were no statistically significant differences in the patients' demographic characteristics or risk factors for RSV hospitalization. When subgroup analyses were conducted, there were still no statistically significant differences. The administration of palivizumab prophylaxis during the entire RSV season is important in VLBWI with BPD, regardless of their gestational age and birth weight, or previous ventilator dependency.
Antibiotic Prophylaxis/*methods ; Antiviral Agents/*therapeutic use ; Birth Weight ; Bronchopulmonary Dysplasia/*complications ; Female ; Gestational Age ; Hospitalization/statistics & numerical data ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; *Infant, Very Low Birth Weight ; Length of Stay ; Male ; Palivizumab/*therapeutic use ; Prospective Studies ; Respiratory Syncytial Virus Infections/drug therapy/*epidemiology/prevention & control ; Respiratory Syncytial Viruses/drug effects ; Risk ; Risk Factors

PURPOSE: Recently, mothers stay in postpartum care centers (PPCCs) instead of their home for a few weeks after child birth in Korea. The policies of breastfeeding in those facilities can affect the success of breastfeeding. We studied the breastfeeding practice of mothers who stayed in PPCCs and the policies of these facilities. METHODS: We conducted a survey using questionnaires about breastfeeding practice on mothers who visited the Departments of Pediatrics of Cheil General Hospital, Yeungnam University Hospital, Dongsan Medical Center and Chonnam University Hospital, from February 2010 to July 2010. We also conducted another survey on the PPCCs. RESULTS: We collected 349 replies from mothers and 151 responses from PPCCs. 97.4% of mothers had been encouraged breastfeeding, but only 60.3% of mothers practiced rooming-in care, and only 15.2% of them performed it for 24 hours. Milk bottle was used in 92.6% to supply formula instead of cup or spoon. 54.8% of mothers used breast pump unnecessarily to collect breast milk to feed their babies using bottle. 77.3% of mothers withheld breastfeeding in case of cracked nipples, mild jaundice or loose stool. Only 18% of personnels in PPCCs was educated about breastfeeding. Educational materials were provided in only 67.1% of PPCCs. Regional difference was noted in rooming-in care, lecture, feeding device for supplementation and breastfeeding in case of mild jaundice, loose stool or cracked nipples. CONCLUSION: Insufficiently trained people in PPCC may make mothers difficult to breastfeed. It is necessary for the people in PPCCs to be educated for breastfeeding appropriately.
Breast ; Breast Feeding ; Child ; Hospitals, General ; Humans ; Jaundice ; Korea ; Milk ; Milk, Human ; Mothers ; Nipples ; Parturition ; Pediatrics ; Postnatal Care ; Postpartum Period ; Surveys and Questionnaires ; Rooming-in Care